title: [Complications after femoral lengthening with ring fixators in congenital femoral deficiency].
abstract: OBJECTIVE
  Congenital femoral deficiency (CFD) is a rare and complex deformity. The results and complications of surgical correction of this deformity using ring fixators (Ilizarov/Taylor Spatial Frame) have been evaluated.
  
  
  METHODS
  We retrospectively reviewed a consecutive series of 30 patients with CFD, between the ages of 3.3 and 17 years (mean, 9.3 years), with 35 lengthening procedures. Ten cases were treated with an Ilizarov frame, 25 cases with a Taylor Spatial Frame (TSF).
  
  
  RESULTS
  The average lengthening at femoral osteotomy was 44.3 mm. Nine patients underwent an additional tibial lengthening by an average of 24.2 mm. The total lengthening was 50.5 mm (28-85 mm). A fracture after removal of the fixator occurred in 25.7% of the cases, and a pin-site infection with the subsequent need of operative revision was found in 8.5%. A subluxation of the knee joint was observed in 11.4% and a persistent limitation of the knee joint range of motion in 22.8%.
  
  
  CONCLUSIONS
  Despite several complications, the use of ring fixators, especially the TSF, is an effective method for treatment of this complex deformity. The complication rate was similar with the use of either ring fixator. Some complications can be decreased with experience. The risk of knee dislocation can be reduced by joint bridging and fractures after frame removal can be avoided by prophylactic rodding.
authors.affiliation: Ortopedická nemocnice Speising, oddělení dětské ortopedie, Vídeň, Rakousko.
authors.forename: R
authors.initials: R
authors.lastname: Ganger
authors.forename: C
authors.initials: C
authors.lastname: Radler
authors.forename: J
authors.initials: J
authors.lastname: Chomiak
authors.forename: A
authors.initials: A
authors.lastname: Handlbauer
authors.forename: F
authors.initials: F
authors.lastname: Grill
authors.forename: P
authors.initials: P
authors.lastname: Dungl
mesh_terms: D001852:Bone Lengthening / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002648:Child; D002675:Child, Preschool; D005269:Femur / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects; D010027:Osteotomy; D011859:Radiography; D013977:Tibia / Q000601:surgery